The long list of warnings about community screening programs is getting longer

Otis Brawley, MD, chief medical officer of the American Cancer Society has said:

“Many of these free screening things are designed more to
get patients for hospitals and clinics and doctors than they are to
benefit the patients. That’s a huge ethical issue that needs to be
addressed.”

Three authors, including the executive vice president and chief
executive of the American College of Physicians, wrote in the Annals of
Internal Medicine about the “Ethics of Commercial Screening Tests.“ Excerpt:

“Misuse of preventive services, under the guise of saving
lives and saving costs, may actually lead to increased cost and harm
due to unnecessary follow-up testing and treatment with associated
avoidable complications. We suggest that medical entities and physicians
withdraw from the unethical business of promoting unproven and
potentially harmful screening tests.”

And now the Public Citizen organization has added its voice to the warnings.

The organization has written to 20 hospitals in eight states
urging them to “sever their relationships with HealthFair Health
Screening because the company’s heavily promoted, community-wide
cardiovascular health screening programs are unethical and are much more
likely to do harm than good.”

Winter Park, Fla.-based HealthFair – and most of its
hospital and medical institution partners – peddles inexpensive
cardiovascular disease screening packages to people living near the
hospitals and institutions without identifying who has relevant risk
factors that would make each of the screening tests medically
appropriate. HealthFair’s basic cardiovascular screening packages
include six tests that, among other things, take pictures of the heart,
measure its electrical activity and look for blockages in arteries.

The screening tests are performed in buses, often bearing the
names and logos of both the partner hospital or medical institution and
HealthFair. The buses roam the surrounding geographic areas of the
partner hospitals and medical institutions.

These screening packages are promoted directly to consumers
through: (1) online advertisement on HealthFair’s website and on the
websites of most of the partnered hospitals and medical institutions,
and (2) in at least some cases, through solicitation letters mailed
directly to people’s homes. The promotions rely on fearmongering and
erroneously suggest that for most adults in the general population,
these screening tests are useful in the prevention of several
potentially life-threatening cardiovascular illnesses – including heart
attacks, strokes and ruptured abdominal aortic aneurysms – and make them
sound like an appealing bargain.

In fact, such indiscriminate and widespread testing is more
likely to cause harm than good, Public Citizen said in letters sent to
the hospitals and medical institutions today. For example, many people
undergoing such screening will have false-positive results (appear to
show an abnormality that is actually not present) or results showing
minor abnormalities that would never cause symptoms or illness. Both
circumstances can lead to additional unnecessary and risky tests and
treatments that will harm some people, cause unfounded anxiety, and cost
patients and insurance companies.

Such widespread screenings are not recommended by medical experts
because each of the six tests either benefits only appropriately
selected high-risk patients or has not been scientifically shown to
provide any clinically meaningful benefit to anyone.

“It is exploitative to promote and provide medically
non-beneficial testing through the use of misleading and fearmongering
advertisements in order to generate medically unnecessary but profitable
referrals to the institutions partnered with HealthFair,” said Dr.
Michael Carome, director of Public Citizen’s Health Research Group.
“Consumers are being misled to believe that these screening packages are
beneficial when in reality, many will undergo additional unnecessary
testing, likely putting them at greater risk, not saving them any money
and adding unneeded anxiety.”

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